Updated: Jul 20, 2022
While other facilities have dramatically expanded their mental health staffing, the Hampshire Sheriff’s Office has not added any additional mental health staff and progress towards meaningful treatment remains stagnant.
Removing the stigma surrounding mental health is an ongoing task in the field of corrections. As those barriers are progressively removed the task then falls to treatment. What treatment groups are available? What medication would be best? Do we have enough clinicians and providers to give appropriate care? Does staffing allow for intensive therapy, regular follow ups and assessments? What happens when we have more need than resources? And what about the mental health of the staff? How do we look out for them, too?
These are all difficult questions to answer. Society has gotten much better over the last many years about accepting mental health as an aspect of overall health. But, the resource allocation has not kept pace with the demand for services and that is particularly true in corrections. According to the Correctional Funding Report published by the Special 101 Commission in Massachusetts earlier this year, approximately 50% of individuals entering the Hampshire County Sheriff’s Office have a facility diagnosis of a serious mental health disorder. That number rises to nearly 70% when you ask the individual themselves, many of whom, because they don’t qualify for a mental health diagnosis but still experience mental health issues, self medicate with drugs and alcohol.
And what of the staff? Corrections has gotten much better about recognizing the detrimental effects incarceration can have on the mental health of those held by the system, but what hasn’t been well addressed is what the corrections system does to the mental health of those in service to the system.
The Hampshire County Sheriff’s Office has not been spared this impact. In the last 10 years, despite the significant increase in mental health disorder diagnosis in our population, the staff available to treat those individuals has remained stagnant. While other facilities have dramatically expanded their mental health staffing, the Hampshire Sheriff’s Office has not added any additional mental health staff. Caitlin has spent the past 10 years facing this crisis head on. With individuals who pass through the doors of the jail seeking medications and treatment, to staff who deal with not only the incredibly mundane but also the incredibly dangerous work of corrections, Caitlin has been alongside of, or in it, too; in a way no other candidate has. As such, a Sepeda Administration would:
Create a Mental Health Department. Presently the Hampshire Sheriff’s Office contracts its mental healthcare out to ServiceNet. The single Clinician (MSW) and single Provider (Psychiatrist) are not fully able to meet the needs of the individuals in the care of the facility. More than half of the facility, including several DMH clients at any one time, fall directly on their caseload. This is an unmanageable number to effectively treat in a group setting let alone in any meaningful individual setting. This situation will not change until staffing changes dramatically. The facility mental health offerings presently serve the needs of this contract rather than the needs of the facility.
The facility will have its own department with its own employees which it can schedule and make available to the facility as the facility requires. As it stands now, Mental Health is available only M-F, no holidays, largely during standard business hours. Mental health crises do not take weekends and holidays off. The number and availability of mental health staff needs to be significantly increased to meet facility needs. Too often in the current Administration, security staff with CIT training are utilized in a mental health capacity for lack of mental health staff: this staff, with this training, are not a substitute for regular mental health care and should not be utilized as such.
Mental Health staff should be licensed providers who can provide a broad range of treatment and diagnostic care. Licensed Clinical Social Workers, Licensed Mental Health Clinicians and Certified Correctional Healthcare Providers-Mental Health (CCHP-MH) should be employed. Active recruiting measures will focus on hiring this staff.
Regular, frequent and timely check-ins with mental health providers will take place; not only during the intake assessment process, but with regularity after court appearances, at staff and individual requests, leading up to release, after medication adjustments etc. The staff presently does not exist to meet any of these needs with regularity and there is no initiative on the part of the present Administration to change this dynamic. Staff recruitment and schedule adjustments in the Sepeda Administration will address the bulk of these concerns.
All staff should be trained in Critical Incident Training (CIT). Most of the security staff is presently trained, but not all, and this training certainly does not exist across all departments. The bulk of this training lies with correctional staff, but treatment, medical and education would benefit as well. Trainers are presently on staff but are not utilized to meet this goal as the current Administration has not made this a priority goal. It will be in the Sepeda Administration.
Staff debriefings around critical incidents should regularly take place. As a nurse at the facility for nearly 10 years Caitlin responded to many significant suicide attempts, staff assaults and other violent altercations. Security staff nearly always deal with more. At no point after those events was a formal staff debriefing undertaken. Staff should be formally debriefed, offered the opportunity to contribute suggestions for improvements and be given feedback on their role. Peer support measures should be actively in place and utilized.
Employee wellness should be a priority. Staff who feel both physically, mentally and emotionally well, and feel prepared and supported in their job are more successful in corrections management. A focus on employee health and wellbeing should be as much of a focus as it is for justice involved individuals.
Mental health, along with substance abuse issues, are the primary factors at play with justice involved individuals. Full stop. As a correctional nurse who spends her days working face to face and hand in hand with those individuals, and all aspects of the criminal justice system, in their care and rehabilitation, Caitlin is the most prepared candidate to tackle these challenges and move corrections into the phase of rehabilitation and care.